Provider Demographics
NPI:1396403036
Name:SHEPHERD, CHRISTINE (LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14795 MACDUFF DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-4102
Mailing Address - Country:US
Mailing Address - Phone:317-563-1855
Mailing Address - Fax:
Practice Address - Street 1:DAYHET AL NAKHEEL KHALDOUN HAMD ALLAH ALD'AJA ST #3
Practice Address - Street 2:AMMAN
Practice Address - City:AMMAN
Practice Address - State:AMMAN
Practice Address - Zip Code:11181
Practice Address - Country:JO
Practice Address - Phone:317-563-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004042A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health